ISLAND VOICES

Hawaii health plans tops in U.S. for managing medical-service dollars

By Jennifer Diesman

POSTED: 01:30 a.m. HST, May 10, 2012

~~<p>Despite seemingly negative news reporting to the contrary, health plans in Hawaii have proven to be the best in the nation at managing premium dollars by spending more on medical services and less on administrative expenses. This distinction is demonstrated by the fact that Hawaii is the only state in the nation where health plans do not owe consumers refunds as part of the federal Affordable Care Act.</p><p>Until recently, medical loss ratio (MLR) was an obscure term found in the act. It describes the percentage of premium dollars spent by health insurers on health care for their members, from visits to a doctor's office to hospital services to prescription drugs. The MLR states that insurers must spent at least 80 percent to 85 percent of dues money on health care. Insurers that fail to hit that mark annually must provide refunds to individuals and businesses.</p>~~

Despite seemingly negative news reporting to the contrary, health plans in Hawaii have proven to be the best in the nation at managing premium dollars by spending more on medical services and less on administrative expenses. This distinction is demonstrated by the fact that Hawaii is the only state in the nation where health plans do not owe consumers refunds as part of the federal Affordable Care Act.

Until recently, medical loss ratio (MLR) was an obscure term found in the act. It describes the percentage of premium dollars spent by health insurers on health care for their members, from visits to a doctor's office to hospital services to prescription drugs. The MLR states that insurers must spent at least 80 percent to 85 percent of dues money on health care. Insurers that fail to hit that mark annually must provide refunds to individuals and businesses. Login for more...